Revision Hip Arthroscopy in the Native Hip: A Review of Contemporary Evaluation and Treatment Options

Abstract

Hip arthroscopy is a reproducible and efficacious procedure for the treatment of femoroacetabular impingement syndrome (FAIS). Despite this efficacy, clinical failures are observed, clinical entities are challenging to treat, and revision hip arthroscopy may be required. The most common cause of symptom recurrence after a hip arthroscopy that leads to a revision arthroscopy is residual cam morphology as a result of inadequate femoral osteochondroplasty and restoration of head–neck offset, though several other revision etiologies including progressive chondral and labral pathologies also exist. In these cases, it is imperative to perform a comprehensive examination to identify the cause of a failed primary arthroscopy as to assess whether or not a revision hip arthroscopy procedure is indicated. When a secondary procedure is indicated, approaches may consist of revision labral repair, complete labral reconstruction, or labral augmentation depending on labral integrity. Gross instability or imaging-based evidence of microinstability may necessitate capsular augmentation or plication. If residual cam or pincer morphology is present, additional resection of the osseous abnormalities may be warranted. This review article discusses indications, the evaluation of patients with residual symptoms after primary hip arthroscopy, and the evaluation of outcomes following revision hip arthroscopy through an evidence-based discussion. We also present a case example of a revision hip arthroscopy procedure to highlight necessary intraoperative techniques during a revision hip arthroscopy.

Do patients with femoroacetabular impingement syndrome who undergo hip arthroscopy display improved alpha angle (magnetic resonance imaging) and radiographic hip morphology?

“…However, studies have shown that an elevated LCEA has been observed to be associated with risk of requiring revision surgery. 18,21 Femoral head extrusion index indicates the percentage of uncovered femoral head, with a normal range of 17%-27%. 20 The mean values of extrusion index of participants in PHT were within the normal range prior to the interventions.…”

“…This brought the mean LCEA of participants who underwent arthroscopic surgery closer to the normal range, indicating that arthroscopic surgery reduces over‐coverage. However, studies have shown that an elevated LCEA has been observed to be associated with risk of requiring revision surgery 18,21 …”

“…However, studies have shown that an elevated LCEA has been observed to be associated with risk of requiring revision surgery. 18 , 21 …”

The Dopamine D1 Receptor Attenuates Titanium Particle-Induced Inhibition of Osteogenesis by Activating the Wnt Signaling Pathway

“…However, revision surgery is difficult due to trauma, high cost, and postoperative complications and will further increase the risk of further revision, resulting in a vicious cycle. Preventing and curing aseptic loosening of artificial joints is a great challenge in orthopedics [4][5][6].…”